| ObjectiveThis study aims to investigate the current situation of HIV testing behavior among men who have sex with men(MSM)in Dali area,and to explore the factors influencing HIV testing behavior through a logistic regression analysis based on the theoretical analysis framework of the Anderson model.Furthermore,a structural equation model will be established to analyze the direct and indirect influencing factors and their paths on HIV testing behavior among MSM in Dali area,providing a scientific basis and reference for the development of prevention measures and intervention programs by the AIDS care team.MethodsA cross-sectional study design was adopted,and a snowball sampling method was used to select 361 MSM as research subjects from April 2022 to November 2022 at HIV testing sites in Dali Prefecture according to unified inclusion and exclusion criteria.The data were collected through on-site investigations and online electronic questionnaires on a social networking app.The research tool was designed and classified based on the theoretical framework of the Anderson model,including predisposing factors(age,place of residence,sexual orientation,sexual role,occupation,education level,marital status,attitudes and history of HIV testing,high-risk behavior in the past 6 months,etc.),enabling resources(economic status,ways of obtaining HIV-related knowledge,choice of testing methods,distance between testing sites and homes,social support),and demand factors(self-assessed mental health,self-identity,comfort in seeking medical care).SPSS version 25.0 was used for statistical analysis,including descriptive statistics,chi-square test,non-parametric tests,and multi-category logistic regression analysis.Additionally,AMOS version 22.0 was used to analyze the influencing mechanism and effect of HIV testing behavior among MSM.Results(1)The mean age of the 361 research subjects was 32.13±12.69 years old,with the majority(157,43.5%)falling in the age range of 21-30 years old.The HIV testing rate in the past 6 months was 72.6%.(2)Univariate analysis results showed that HIV testing behavior among MSM was significantly associated with age,education level,occupation,economic status,marital status,sexual orientation,sexual role,number of sexual partners in the past 6 months,condom use during anal sex with same-sex partners,disclosure of sexual orientation to family members,ways of obtaining HIV-related knowledge,personal history of HIV testing,preferred testing locations or methods,self-identity,attitudes towards HIV testing,social support,comfort in seeking medical care,and self-reported mental health status(P<0.05).(3)Multivariate analysis results showed that predisposing factors(education level,economic status,sexual role,number of sexual partners in the past 6 months,condom use during anal sex with same-sex partners,personal history of HIV testing,and attitudes towards HIV testing),enabling resources(ways of obtaining HIV-related knowledge and social support),and demand factors(self-identity,comfort in seeking medical care,and self-reported mental health status)had a significant impact on HIV testing behavior among MSM in Dali Prefecture(P<0.05).(4)The structural equation model revealed that predisposing factors had a direct effect of 0.047 on HIV testing behavior among MSM in the past 6 months.Predisposing factors also had an indirect effect of 0.122 on HIV testing behavior through demand factors.Enabling resources had a direct effect of 0.878 on HIV testing behavior among MSM.Demand factors had a direct effect of 0.137 on HIV testing behavior among MSM in the past 6 months.Conclusion(1)The study found that HIV testing rates were low among men who have sex with men(MSM)in Dali Prefecture,Yunnan Province in the past 6 months.The population characteristics were mainly low-income individuals with limited education,and a certain proportion of the MSM group in Dali had high-risk sexual behaviors.Additionally,the proportion of married and cohabitating individuals of the opposite sex accounted for more than half of the total,indicating a high risk of HIV transmission from high-risk groups to the general population in Dali.(2)The influencing factors of HIV testing behavior among MSM in Dali Prefecture were mainly predisposing factors(education level,economic status,sexual role,number of sexual partners in the past 6 months,condom use during anal sex with same-sex partners,personal history of HIV testing,and attitudes towards HIV testing),enabling resources(ways of obtaining HIV-related knowledge and social support),and demand factors(self-identity,comfort in seeking medical care,and self-reported mental health status).To enhance the HIV testing rate among men who have sex with men in Dali region and assist the community in better preventing and managing the spread of HIV/AIDS,it is suggested that the specialized HIV/AIDS nurses in the region should have a thorough understanding of the needs and behavioral characteristics of this population,facilitate their access to resources,develop a planned follow-up program,and provide targeted nursing interventions.(3)Predisposing factors had a direct effect on HIV testing behavior among MSM in the past 6 months,and these factors could also have an indirect effect through demand factors.Enabling resources had a direct effect on HIV testing behavior among MSM,while demand factors had a direct effect on HIV testing behavior among MSM in the past 6 months.According to the total effect size,enabling resources > demand factors > predisposing factors.Therefore,based on the varying impacts of different factors on the HIV testing behaviors of this population,specialized HIV/AIDS nurses can develop scientific and targeted nursing measures and diversified intervention methods to consolidate and further enhance the effectiveness of HIV prevention and control efforts in the entire province.This will contribute to achieving China’s first goal of "90-90-90" for HIV prevention and control as soon as possible. |
